Objective: To investigate the relationships between age and outcome in head injured patients.
Methods: A prospective study of all patients with a head injury admitted to the regional centre at Newcastle General Hospital, UK between 1987 and 2000 (excluding 1989 and 1991) has been carried out. Data collected included cause of injury, age and gender of patient, GCS at admission, presence of haematoma, whether surgery was performed and outcome at discharge using GOS.
Results: During the 12 years of the study a total of 7154 patients were admitted: 28% were aged under 10, 20% 10-19, 15% 20-29, 10% 30-39 and 26% 40 or over. The age span was from 8 days to 99 years (median 21 years) and three quarters were male. GCS was 15 for 54%, 17% had a mild injury (GCS 13 & 14), 9% a moderate injury (GCS 11 & 12) and 19% a severe injury (GCS £ 8). One fifth had a haematoma of which 11% were subdural, 6% extradural and 4% ICH. Over two thirds (70%) made a good recovery by the time of discharge or transfer from the regional centre while 7% died or were vegetative. The main causes of head injury were a fall (49%) road traffic accident (24%) and assault (16%). During the period of the study there was little change in the age profile of patients admitted in each year. Older patients were more likely to be female and to have a subdural or intracerebral haematoma that required surgery. Their GCS on admission tended to be lower than younger patients and the cause of their head injury was more likely to be from a fall. Age, initial GCS and presence of a haematoma were significant factors in relation to outcome.
Conclusions: The profile of head injury admissions over the 14 years of this study has remained constant in relation to age, injury severity and mortality. The unfavourable outcome for older patients remains even after adjusting for their lower admission GCS and subdural or intracerebral haematomas.
Gregson BA, Stobbart L, Ogungbo B, Chambers IR, Mendelow AD. Relationships between age and outcome in head injured patients in Newcastle. Euroacademia Multidisciplinaria Neurotraumatologica in Graz, Austria, 21-23 May, 2003.
Dr. Iain R. Chambers, Cleveland Unit, Middlesbrough. Tel: +44 (0)1642-854-778.